Diagnosis of Acute Glaucoma Attack Using a Quantitative Pupillometer: A Case Report

Acute glaucoma attacks cause a sudden increase in intraocular pressure. In addition to ocular symptoms such as redness, visual impairment, and eye pain, it also presents with headache and vomiting. It is diagnosed using a slit lamp microscope, gonioscope, and anterior segment optical coherence tomography. A 72-year-old man visited the emergency room complaining of repeated vomiting and a throbbing headache in the right temporal region. Conjunctival congestion of the right was observed. However, this was not considered important at the initial examination stage because he had been diagnosed with a dry eye at a local ophthalmology clinic. No intracranial bleeding was found on a head CT scan. Glaucoma was suspected and diagnosed based on the difference between the left and right neurological pupil index (NPi) and miosis rate (CH) measured by quantitative pupillometry. Quantitative pupillometry is a simple examination method not dependent on the examiner's skill. If a difference between the left and right NPi and CH measured by quantitative pupillometry is observed in patients with headaches, it can help diagnose acute glaucoma attacks.